Around Florida: Legislators to assess treatment of mentally ill

TALLAHASSEE | Faced with increasing numbers of cases, shrinking state funding and the transition to a new system that has irked providers, Florida lawmakers will use this year’s session to assess the priorities of how the state deals with its mentally ill.

The reform push is set against the backdrop of gunmen with apparent mental illnesses committing mass shootings at an elementary school in Connecticut and a theater in Colorado. The incidents captured national attention and put mental health in the limelight.

Experts say Florida implemented a reactionary approach, failing to identify those with mental illness before the issue deteriorates.

Since 2002, there has been an increase of more than 40,000 annual instances of patients being involuntarily examined for mental health issues, a process allowed under Florida’s Baker Act.

Because the law requires a facility to file a petition to hold someone for more than 72 hours, it’s common for patients to be released without proper treatment and later be readmitted.

The state’s mental health system has been transitioning from one that involved hundreds of providers to a regional approach that is aimed at localizing care and wringing savings out of the system.

Florida is now broken into seven regions, with one “managing entity” in each region contracting with the state to coordinate care. The program was created in 2001, but state contracts weren’t shifted to the managing entities until July 2012.

“In the past … we had over 500 contracts with mental health and substance abuse providers all over the state,” Siedlecki said. “To say the least, the system was unwieldy and difficult to manage.”

Along with taking centralized control out of Tallahassee, Siedlecki said his department estimates that over the next four years it will save $185 million in administrative costs, which will help serve an additional 40,000 patients.

Providers involved in the past system, however, are skeptical of the shift.

“In terms of my area, managing entities have only been in operation for two months … I don’t know how they can competently say we are going to save all these dollars,” John Romano, CEO of New Horizons of the Treasure Coast and Okeechobee, told the House panel.

He said the state stripped $450,000 from a contract his group has to help fund the area’s managing entity.

“No doubt providers all over the state are really nervous,” said Marzullo, whose group receives no state funds. “They don’t know what’s going to happen next.”

After 20-year-old Adam Lanza shot and killed 26 people at Sandy Hook Elementary School in Newtown, Conn. before turning the gun on himself, officials across the country trained much of their focus on how to prevent future school shootings.

One reform being discussed is letting the department coordinate with school districts, which currently is not happening.

David Wheeler, school psychology consultant with the Florida Department of Education, told the House panel that nationally about 20 percent of school-age children suffer from some form of mental illness.

“That means we would expect about 500,000 of our children and adolescents in Florida have mental health issues,” he said.

It’s not a surprise to Marzullo.

“If something like Sandy Hook were to happen in Jacksonville,” she said, “I would not at all be surprised.”

So much for the good labor feelings

After a less than rosy couple of years, things were looking up for the relationship between Florida’s GOP-led government and state workers.

Gov. Rick Scott proposed $480 million for teachers’ pay increases last week, and legislative leaders have hinted that they might consider raises for other state workers.

“I think that teachers are some government workers who deserve to have better compensation,” Senate President Don Gaetz, R-Niceville, told reporters Wednesday. “But I know corrections officers, I know highway patrolmen … who deserve a raise. And six years is a long time to wait.”

But the fuzzy feeling abruptly ended Thursday.

A proposal workshopped in a House panel would shift state workers hired after July 1, 2014, into a 401(k)-style retirement plan. They are currently under a defined-benefit plan, which requires the state to make a defined monthly pension contribution.

Though the proposal would not impact current employees, public-worker unions and the Democrats whose campaigns they help finance will fiercely oppose the measure. They point to the fact that the Florida Retirement System is funded at nearly 87 percent, which is above the national average.

The overhaul this year is a priority of House Speaker Will Weatherford, R-Wesley Chapel, who in the past has called Florida’s pension system a “ticking time bomb.”

Tweaks to the proposal moving forward will, in part, be based on a study of the potential impacts of a pension-system overhaul commissioned by the House. It is expected to be released in the next few weeks.

“If the study comes back, and it is not where we thought it was going to be, I don’t know how much appetite members are going to have to do something like that,” Weatherford said, according to the News Service of Florida.